Baseline 3D-ADC outperforms 2D-ADC in predicting response to treatment in patients with colorectal liver metastases
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To examine the value of baseline 3D-ADC and to predict short-term response to treatment in patients with hepatic colorectal metastases (CLMs).
Liver MR images of 546 patients with CLMs (2008–2015) were reviewed retrospectively and 68 patients fulfilled inclusion criteria. Patients had received systemic chemotherapy (n = 17), hepatic trans-arterial chemoembolization or TACE (n = 34), and 90Y radioembolization (n = 17). Baseline (pre-treatment) 3D-ADC (volumetric) of metastatic lesions was calculated employing prototype software. RECIST 1.1 was used to assess short-term response to treatment. Prediction of response to treatment by baseline 3D-ADC and 2D-ADC (ROI-based) was also compared in all patients.
Partial response to treatment (minimum 30% decrease in tumor largest transverse diameter) was seen in 35.3% of patients; 41.2% with systemic chemotherapy, 32.4% with TACE, and 35.3% with 90Y radioembolization (p = 0.82). Median baseline 3D-ADC was significantly lower in responding than in nonresponding lesions. Area under the curve (AUC) of 3D-ADC was 0.90 in 90Y radioembolization patients, 0.88 in TACE patients, and 0.77 in systemic chemotherapy patients (p < 0.01). Optimal prediction was observed with the 10th percentile of ADC (1006 × 10−6 mm2/s), yielding sensitivity and specificity of 77.4% and 91.3%, respectively. 3D-ADC outperformed 2D-ADC in predicting response to treatment (AUC; 0.86 vs. 0.71; p < 0.001).
Baseline 3D-ADC is a highly specific biomarker in predicting partial short-term response to treatment in hepatic CLMs.
• Baseline 3D-ADC is a highly specific biomarker in predicting response to different treatments in hepatic CLMs.
• The prediction level of baseline ADC is better for90Y radioembolization than for systemic chemotherapy/TACE in hepatic CLMs.
• 3D-ADC outperforms 2D-ADC in predicting short-term response to treatment in hepatic CLMs.
KeywordsLiver neoplasms Colorectal neoplasms Diffusion magnetic resonance imaging RECIST
Apparent diffusion coefficient
Area under the curve
Health Insurance Portability and Accountability Act
Magnetic resonance imaging
Response evaluation criteria in solid tumors
Receiver operator characteristics
Region of interest
Selective internal radiation therapy
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Dr Ihab R. Kamel.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• performed at one institution
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